Environmental contributions to allergic disease

Indoor Pollen Concentrations of Mountain Cedar (Juniperus ashei) during Rainy Episodes in Austin, Texas

Standard pollen monitoring programs evaluate outdoor pollen concentrations; however, information on indoor pollen is crucial for human wellbeing as people spend most of the day in indoor environments. In this study, we investigated the differences in indoor mountain cedar pollen loads between rooms of different uses and with different ventilation at The University of Texas in Austin and focused on the effect of rainy episodes on indoor/outdoor ratios of pollen concentrations. Pollen were sampled outdoors and indoors, specifically in seven rooms and in two thermal labs with controlled ventilation, during the daytime on 6 days in 2015. We calculated daily pollen concentrations, campaign pollen integrals (CPIn, the sum of all daily pollen concentrations) and ratios between indoor and outdoor concentrations (I/O ratio). Pollen concentrations differed substantially based on features related to room use and ventilation: Whereas the highest CPIn was observed in a room characterized by a frequently opened window and door, the smallest CPIn was related to a storeroom without any windows and no forced ventilation. Our results showed that rainy episodes were linked to a higher mean I/O ratio (0.98; non-rainy episodes: 0.05). This suggests that pollen accumulated indoors and reached higher levels than outdoors. Low ratios seem to signal a low level of risk for allergic people when staying inside. However, under very high outdoor pollen concentrations, small ratios can still be associated with high indoor pollen levels. In turn, high I/O ratios are not necessarily related to a (very) high indoor exposure. Therefore, I/O ratios should be considered along with pollen concentration values for a proper risk assessment. Exposure may be higher in indoor environments during prevailing precipitation events and at the end of the pollen season of a specific species. Standardized indoor environments (e.g., thermal labs) should be included in pollen monitoring programs.

Mechanism analysis of toxicity of sodium sulfite to human hepatocytes L02

Food additives are widely used in various food products to preserve the taste, color, and other qualities. However, if they are used improperly or exceed the standard, they will cause damage to the human body. Sulfite is a commonly used food additive to prevent oxidation from deteriorating the nutrients in foods, it has been widely used as a bleaching agent in the food industry for a long time. In this study, human hepatocytes L02 cells were used as a model cell line to evaluate the toxicity of sodium sulfite. The cell morphology and cell proliferation were affected by sodium sulfite treatment, and apoptosis was detected. Transcriptome sequencing showed 97 differentially expressed genes (DEGs) between the experimental group (IC50) and the control group (MOCK), and 27 differentially expressed genes related to cell apoptosis, metabolism and inflammation were selected for validation by qPCR. Among them, 13 significantly upregulated genes and 14 significantly downregulated genes were identified by qPCR. The results showed that with increase of sodium sulfite concentration, the morphology of L02 changed, cell proliferation and activity were inhibited, and sodium sulfite caused apoptosis in a concentration- and time-dependent manner. The resulting toxic mechanism inhibits proliferation, damages the mitochondrial integrity, and promotes apoptosis.

Increasing Juniperus virginiana L. pollen in the Tulsa atmosphere: long-term trends, variability, and influence of meteorological conditions

In the Tulsa area, the Cupressaceae is largely represented by eastern red cedar (Juniperus virginiana L.). The encroachment of this species into the grasslands of Oklahoma has been well documented, and it is believed this trend will continue. The pollen is known to be allergenic and is a major component of the Tulsa atmosphere in February and March. This study examined airborne Cupressaceae pollen data from 1987 to 2016 to determine long-term trends, pollen seasonal variability, and influence of meteorological variables on airborne pollen concentrations. Pollen was collected through means of a Burkard sampler and analyzed with microscopy. Daily pollen concentrations and yearly pollen metrics showed a high degree of variability. In addition, there were significant increases over time in the seasonal pollen index and in peak concentrations. These increases parallel the increasing population of J. virginiana in the region. Pollen data were split into pre- and post-peak categories for statistical analyses, which revealed significant differences in correlations of the two datasets when analyzed with meteorological conditions. While temperature and dew point, among others were significant in both datasets, other factors, like relative humidity, were significant only in one dataset. Analyses using wind direction showed that southerly and southwestern winds contributed to increased pollen concentrations. This study confirms that J. virginiana pollen has become an increasing risk for individuals sensitive to this pollen and emphasizes the need for long-term aerobiological monitoring in other areas.

IgE mediated sensitisation to aeroallergens in an asthmatic cohort: relationship with inflammatory phenotypes and disease severity

BACKGROUND

Atopy is known to play an important role in the asthmatic disease. The main objective of this study was to evaluate the frequency of sensitisation to common aeroallergens in a cohort of asthmatics with different inflammatory phenotypes and disease severity.

METHODS

We have conducted a retrospective cross-sectional study including 772 asthmatics recruited between 2003 and 2014 in our Asthma Clinic. The patients were defined as asthmatics on the basis of respiratory symptoms together with a positive methacholine test (PC20M) < 16 mg/ml and/or a reversibility to short-acting β2-agonists (salbutamol) ≥ 12% and 200 ml. Sensitisation to house dust mites, grass and birch pollens, cats, dogs and moulds was assessed by RAST and a specific immunoglobulin E (IgE) > 0.35 kU/l was considered as significant. Inflammatory phenotypes were subdivided between pauci-granulocytic (n = 309) (40%), eosinophilic (n = 311) (40%), neutrophilic (N = 134) (17%) and mixed-granulocytic (N = 18) (3%) asthmatics. Severe asthmatics (n = 118) were defined according to the American Thoracic Society (ATS 2000) criteria and compared with mild-to-moderate asthmatics (N = 654).

RESULTS

The eosinophilic phenotype was associated with higher levels of total serum IgE compared with neutrophilic and pauci-granulocytic asthma (p < 0.001 for both). Sensitisation rate to dogs and cats was higher in eosinophilic asthmatics (31% and 37%, respectively, p < 0.01 both) compared with neutrophilic (18% and 23% respectively) and pauci-granulocytic asthmatics (20% and 24%, respectively), while sensitisation rate to house dust mites and moulds were rather similar between the groups (ranging from 33% to 40% and from 10% to 16%, respectively). Severe asthmatics had slightly increased total serum IgE compared with mild-to-moderate asthmatics (p < 0.05) without any difference in the sensitisation rate to common aeroallergens.

CONCLUSION

Eosinophilic asthma exhibits higher total serum IgE and sensitisation rate towards animal dander while clinical severity, though also associated with higher total IgE, did not preferentially relate to any type of common aeroallergens.

Sodium sulfite promotes the assembly and secretion of very low-density lipoprotein in HL-7702 hepatocytes

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Na₂SO₃ can increase the secretion of VLDL and apoB100 of human hepatocytes.

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Na₂SO₃ can increase the expression of MTP and TGH in human hepatocytes.

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Na₂SO₃ can not increase TG levels inside the human hepatocytes, but can increase the extracellular TG level.

This study investigated the effects of Na₂SO₃ on the fat metabolism in human normal diploid HL-7702 (referred as L-02) hepatocytes. After 24 h and 48 h, treatment with different concentrations of Na₂SO₃, the intra and extra-hepatocellular triglyceride (TG) contents of L-02 were determined using chemical-enzymatic method. The contents of very low-density lipoprotein (VLDL) and apolipoprotein B100 (apoB100) in the culture supernatants were determined using enzyme-linked immunosorbent assay (ELISA). Western blot was applied to detect the expressions of fatty acid oxidation and fat synthesis related proteins, VLDL assembly and secretion in L-02 cells.

Results

Na₂SO₃ treatment (10 mM, 24 h/48 h) significantly increased the intra TG level in the hepatocytes. Different concentrations of Na₂SO₃ increased the extra-hepatocellular TG content. After 24 h exposure, the extracellular VLDL levels and secretions of apoB100 in 0.1–10 mM Na₂SO₃ groups were significantly higher than that of the negative control (P < 0.05). Meanwhile, the expression of CPT1 and SREBP1 protein were significantly reduced by Na₂SO₃. MTP and TGH protein expressions were significantly elevated in each Na₂SO₃ treatment group. The expression level of LDLR in hepatocytes was reduced by Na₂SO₃.

Conclusion

Na₂SO₃ exposure may promote the hepatocellular VLDL assembly and secretion, through increasing of MTP and TGH expressions and inhibiting the uptake of extracelluar VLDL.

Orally Administered Bisphenol A Disturbed Antigen Specific Immunoresponses in the Naïve Condition

Bisphenol A [2,2-bis(4-hydoxyphenyl)propane; BPA] is an endocrine disrupter widely used in polycarbonate plastics and epoxy resins. We investigated the effects of orally administered BPA on antigen-specific responses of the naïve immune system.BPA was orally administered to T cell receptor transgenic mice, and the antigen-specific responses of immune cells were investigated. Administered BPA moderately reduced interleukin (IL)-2, 4, and interferon (IFN)-gamma secretion and increases in IgA and IgG2a production.Additionally, it was found that orally administered BPA increased antigen-specific IFN-gamma production of T cells and modified whole antigen presenting cells (APCs) to suppress antigen-specific cytokine production from T cells. These findings suggest that BPA can augment the Th1-type responses of naïve immune systems, though the bioavailability of orally administered BPA was low in our experiments.

Climate change and our environment: the effect on respiratory and allergic disease

Climate change is a constant and ongoing process. It is postulated that human activities have reached a point at which we are producing global climate change. It provides suggestions to help the allergist/environmental physician integrate recommendations about improvements in outdoor and indoor air quality and the likely response to predicted alterations in the earth's environment into his or her patient's treatment plan. It incorporates references retrieved from Pub Med searches for topics, including:climate change, global warming, global climate change, greenhouse gasses, air pollution, particulates, black carbon, soot and sea level, as well as references contributed by the individual authors. Many changes that affect respiratory disease are anticipated.Examples of responses to climate change include energy reduction retrofits in homes that could potentially affect exposure to allergens and irritants, more hot sunny days that increase ozone-related difficulties, and rises in sea level or altered rainfall patterns that increase exposure to damp indoor environments.Climate changes can also affect ecosystems, manifested as the appearance of stinging and biting arthropods in new areas.Higher ambient carbon dioxide concentrations, warmer temperatures, and changes in floristic zones could potentially increase exposure to ragweed and other outdoor allergens,whereas green practices such as composting can increase allergen and irritant exposure. Finally, increased energy costs may resultin urban crowding and human source pollution, leading to changes in patterns of infectious respiratory illnesses. Improved governmental controls on airborne pollutants could lead to cleaner air and reduced respiratory diseases but will meet strong opposition because of their effect on business productivity. The allergy community must therefore adapt, as physician and research scientists always have, by anticipating the needs of patients and by adopting practices and research methods to meet changing environmental conditions.

Eosinophilic airway inflammation and airway hyperresponsiveness according to aeroallergen sensitization pattern in patients with lower airway symptoms

Purpose

Sensitization to specific allergens may be important in the development of allergic airway inflammation and airway hyperresponsiveness (AHR). We evaluated the effect of specific aeroallergen sensitization on eosinophilic airway inflammation and AHR.

Methods

We reviewed retrospectively the clinical data of subjects who underwent skin prick tests to aeroallergens, induced sputum analysis, and methacholine bronchial provocation tests to evaluate lower airway symptoms as well as analyzed the associations between the pattern of aeroallergen sensitization and sputum eosinophilia or AHR.

Results

Of the 1,202 subjects be enrolled, 534 (44.4%) were sensitized to at least one aeroallergen in skin tests. AHR was demonstrated in 23.5% and sputum eosinophilia in 38.8%. Sputum eosinophilia was significantly associated with sensitization to perennial allergens (OR, 1.9; 95% CI, 1.4-2.5), house dust mite (OR, 1.7; 95% CI, 1.3-2.3), dog (OR, 1.9; 95% CI, 1.1-3.3), and cat (OR, 2.1; 95% CI, 1.4-3.4). AHR was associated with sensitization to perennial allergens (OR, 2.7; 95% CI, 2.0-3.7), house dust mite (OR, 2.2; 95% CI, 1.6 3.2), Alternaria (OR, 2.3; 95% CI, 1.2-4.7), and cat (OR, 2.7; 95% CI, 1.7-4.3). Sensitization to more perennial allergens increased the risk for sputum eosinophilia and AHR. There was no relationship with individual seasonal allergens.

Conclusion

The development of airway eosinophilic inflammation and AHR in an adult Korean population was associated with sensitization to perennial allergens rather than seasonal allergens.

Sensitization to airborne ascospores, basidiospores, and fungal fragments in allergic rhinitis and asthmatic subjects in San Juan, Puerto Rico

BACKGROUND

Fungal spores are the predominant biological particulate in the atmosphere of Puerto Rico, yet their potential as allergens has not been studied in subjects with respiratory allergies. The purpose of this study was to determine the level of sensitization of subjects with respiratory allergies to these particles.

METHODS

Serum samples were drawn from 33 subjects with asthma, allergic rhinitis, or nonallergic rhinitis and 2 controls with different skin prick test reactivity. An MK-3 sampler was used to collect air samples and the reactivity of the sera to fungal particles was detected with a halogen immunoassay.

RESULTS

All subjects reacted to at least 1 fungal particle. Thirty-one subjects reacted to ascospores, 29 to basidiospores, 19 to hyphae/fungal fragments, and 12 to mitospores. The median percentage of haloes in allergic rhinitis subjects was 4.82% while asthma or nonallergic rhinitis subjects had values of 1.09 and 0.39%, respectively. Subjects with skin prick tests positive to 3, 2, 1, or no extract had 5.24, 1.09, 1.61, and, 0.57% of haloed particles, respectively. If skin prick tests were positive to basidiomycetes, pollen, animals, or deuteromycetes, the percentages of haloes were 4.72, 4.15, 3.63, and 3.31%, respectively. Of all haloed particles, 46% were unidentified, 25% ascospores, 20% basidiospores, 7% hyphae/fungal fragments, and 2% mitospores. IgE levels and the number of positive skin prick test extracts correlated with the percentage of haloes.

CONCLUSION

In tropical environments, sensitization to airborne basidiomycetes, ascomycetes, and fungal fragments seems to be more prevalent than sensitization to mitospores in subjects with active allergies, suggesting a possible role in exacerbations of respiratory allergies.

A comparative study of asthma, pollen, cat and dog allergy among pupils and allergen levels in schools in Taiyuan city, China, and Uppsala, Sweden

We compared the school environment, asthma and allergy in 10 schools in Taiyuan, China, with eight schools in Uppsala, Sweden. In total 2193 pupils (mean age 13 years) participated. Chinese pupils had more respiratory symptoms, particularly daytime breathlessness after exercise (29.8% vs. 7.1%; P < 0.001), while cat allergy (1.2% vs. 6.6%; P < 0.001) and dog allergy (1.3% vs. 4.0%; P < 0.01) was less common. Cumulative incidence of asthma (1.8% vs. 9.5%; P < 0.001) and doctor's diagnosed asthma (1.2% vs. 9.0%; P < 0.001) were less common in China, indicating an under-diagnosis of asthma. Chinese classrooms were colder (mean 14.7 vs. 21.4 degrees C), more humid (mean 42% vs. 31% RH) and had higher CO2-levels (mean 2211 vs. 761 ppm). Levels of cat (Fel d1), dog (Can f1) allergens were low in settled dust from China (< 200 ng/g dust), but high in airborne dust on Petri-dishes (GM 16.8 ng/m2/day for Fel d1 and 17.7 for Can f1). The Swedish settled dust contained cat, dog and horse allergens in high levels (median 1300 ng/g, 1650 ng/g, 1250 U/g dust, respectively). In conclusion, there were large differences in the school environment, and in respiratory symptom and allergy. Allergen measurements in settled dust only may largely underestimate the classroom exposure. Practical Implications There is a need to improve the school environment, both in China and Sweden. The Swedish schools contained high levels of cat, dog and horse allergens and more amounts of open shelves and textiles that can accumulate dust and allergens. The air measurements indicated that Chinese schools may contain significant amounts of cat and dog allergen, and analysis of settled dust only may not reflect the true allergen exposure. Since the Chinese schools had no mechanical ventilation, they could not fulfill the ventilation standard in winter, and hence there is a need for improving the ventilation. The great discrepancy between respiratory symptoms and reports on asthma, and the high prevalence of attacks of breathlessness without wheeze, may have implication for future questionnaire studies on asthma in China.

Emergency department visits and "vog"-related air quality in Hilo, Hawai'i

Emergency department (ED) visits in Hilo, Hawai'i, from January 1997 to May 2001, were examined for associations with volcanic fog, or "vog", measured as sulfur dioxide (SO(2)) and submicrometer particulate matter (PM(1)). Exponential regression models were used with robust standard errors. Four diagnostic groups were examined: asthma/COPD; cardiac; flu, cold, and pneumonia; and gastroenteritis. Before adjustments, highly significant associations with vog-related air quality were seen for all diagnostic groups except gastroenteritis. After adjusting for month, year, and day of the week, only asthma/COPD had consistently positive associations with air quality. The strongest associations were for SO(2) with a 3-day lag (6.8% per 10 ppb; P=0.001) and PM(1), with a 1-day lag (13.8% per 10 microg/m(3); P=0.011). The association of ED visits for asthma/COPD with month of the year was stronger than associations seen with air quality. Although vog appears influential, non-vog factors dominated associations with the frequency of asthma/COPD ED visits.

Addressing the prevalence of respiratory allergy in the home environment

Respiratory allergy prevalence has always depended both on genetic predisposition and specific environmental allergenic stimulation that leads to sensitization and eventual symptomatic disease. Changes brought about by modern technology that have afforded a higher quality of life have also accidentally increased the levels of many respirable and ingestible allergens in the environment. In many cases these higher levels of exposure have exceeded individual thresholds, resulting in the phenotypic expression of allergy in many individuals who were previously asymptomatic even though they were genotypically predisposed to developing allergies. Prevalence can be decreased only if susceptible populations are identified as early as possible through careful family history taking and appropriate testing for sensitivity and if exposure to selected allergens is controlled.